PUBH1000 Lecture Notes - Lecture 3: Maternal Death

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aquamarinecod406

26 May 2018

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Week 3

Health and wellbeing Data:

Types of health data:

To develop an evidence base for action, we first need to describe how health is

monitored using vital statistics, health records, Census Data and population-based

surveys.

• These all differ in their:

- Coverage

- Quality

- Reliability and

- Frequency

Vital statistics:

Life expectancy, morbidity and mortality rates for the general population, plus

Infant mortality and maternal mortality rate.

• Morbidity is the state of being ill, so a morbidity rate refers to the rate at which a

particular illness occurs in a particular area or populations

- Calculates using the number of deaths by age each year, using age and sex

patterns of death and causes of death.

- Infant mortality has indicators of the level of health in a country:

➔ A characteristic of a community or population that is subject to

measurement (directly or indirectly) and can be used to describe one or

more aspects of that community or population (quality and quantity). An

indicator is a statistic that extracts the best possible information from a

data source for regular monitoring.

• Life expectancy at birth is the most commonly used metric for the purpose of

comparing health status across the population, as well as for comparing

population health status between countries.

- Average number of years a group of people born in the same year could

expect to live, if mortality at each age remains constant in the future.

- Life expectancy measures show clear inequalities between different

populations

• Birth registiries

• Death registries

• Cause of death registries

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Document Summary

To develop an evidence base for action, we first need to describe how health is monitored using vital statistics, health records, census data and population-based surveys: these all differ in their: Life expectancy, morbidity and mortality rates for the general population, plus. Infant mortality and maternal mortality rate: morbidity is the state of being ill, so a morbidity rate refers to the rate at which a particular illness occurs in a particular area or populations. Calculates using the number of deaths by age each year, using age and sex patterns of death and causes of death. Infant mortality has indicators of the level of health in a country: A characteristic of a community or population that is subject to measurement (directly or indirectly) and can be used to describe one or more aspects of that community or population (quality and quantity).

Related Questions

QUESTION 1 1. The relative importance or burden of a disease within a population will depend on a number of factors including : A. Disease frequency B. Disease severity C. Disease consequences D. All of the above

QUESTION 2 1 . With the epidemiologic transition, there is a reduction in malnutrition and _____ . A. Communicable diseases B. Injuries C. Non-communicable chronic diseases D. Mental health disorders

QUESTION 3 1. A major challenge to developing a burden of disease profile in low and middle-income countries relates to A. Unwillingness to share complete information B. Conflicting disease definitions C. Challenges obtaining information related to cause of death D. All of the above

QUESTION 4 1. The demographic transition describes which of the following changes to society A. Changes in birth and death rates that reflect a modern society B. Declines in mortality followed by a reduction in fertility C. A change in the age structure of the population D. All of the above

QUESTION 5 1. Measures of health status that combine mortality and morbidity data A. Facilitate comparisons both within and across populations B. Help estimate the quantitative health benefits from interventions C. Serve as tools to assist with resource allocation D. All of the above

QUESTION 6 1. The disability-adjusted life year is defined as A. A health gap population summary measure that combines time lost due to disability with that lost due to death B. A measure to compare the gap between the current situation to that of an ideal situation C. A measure that combines the amount of healthy life lost due to morbidity with that lost due to injury. D. Answers B and C

QUESTION 7 1. True or false? A key limitation to mortality-based indicators is that they fail to account for the morbidity caused by disease. True False

QUESTION 8 1. The most widely used composite measure of population health is the DALY, and this epidemiological measure is the sum of morbidity and ________data. A. Years of life lost (YLL) B. Morbidity C. Infant mortality rates (IMR) D. none of the above

QUESTION 9 1. What would be the best source of information on adult and infant mortality (in high income countries)? A. Disease registers B. Vital statistics C. Special survey study D. Hospital clinic statistics

QUESTION 10 1. Which term is best used to describe the proportion of people in a population who have a defined disease at a specific point of time? A. DALY B. Incidence C. Mortality rate D. Prevalence

QUESTION 11 1. Which term is best used to describe new cases of disease occurring in a population? A. DALY B. Incidence C. Mortality rate D. Prevalence

QUESTION 12 1. Which term is used to describe the absence or presence of illness or disease? A. Demography B. Morbidity C. Mortality D. Vitality

QUESTION 13 1. Mortality (death indicators) include: A. Mortality rate B. Infant mortality rate C. Neonatal morality rate D. All of the above

QUESTION 14 1. True or false? The value of life is often implicit in the way resource allocation decisions are made, which suggests that these decisions should be as explicit, open, and transparent as possible. True False

QUESTION 15 1. _________________is projected as the number one leading cause of disease burden in 2030. A. Ischemic heart disease B. Diabetes mellitus C. HIV/AIDS D. Unipolar depression

QUESTION 16 1. Some of the negative aspects of globalization include A. Greater insecurity of employment B. Poorer housing and sanitation due to rapid urbanization C. Greater vulnerability to environmental degradation D. All of the above

QUESTION 17 1. Current concerns about climate change focus on several developments including A. Rising global average land and sea surface temperature B. Increasing frequency of extreme weather conditions C. Both A and B D. None of the above

QUESTION 18 1. True or false? Diseases carried by mosquitoes are especially sensitive to meteorological conditions because they are vulnerable to changes in the ambient temperature. As a result of changing temperatures, infectious diseases such as malaria and dengue have decreased in incidence and geographic range. True False

QUESTION 19 1. True or false? International cooperation of infectious disease control has a long history that includes obligatory reporting of outbreaks of specific diseases. However, compliance with obligatory reporting has been poor due to economic consequences that have often accompanied notification of disease outbreaks. True False

QUESTION 20 1. True or false? Globalization is a relatively new phenomenon that began in the mid-20th century. True False

The Kaiser Family Foundation (KFF) is a private, not-for-profit foundation devoted to healthcare and health policy issues. One section of its website is called the United States Global Health Policy section. this section collects and presents health data from numerous sources in a user-friendly format.

Go to the State Data section of the KFF United States Global Health Policy website and find the following population health and financial indicators for our great state of Texas: infant mortality rate, male and female life expectancy, obesity and smoking prevalence, health care expenditures per capita, and health insurance coverage. Poke around at the other data available on this website, look up topics that relate to what you do or hope to do after graduation. Then review the numbers for Texas and compare the data to Massachusetts.

In your response to this post, please explain what you found. What stood out to you? Where did Texas and where did Massachusetts succeed? Why do you think Texas did better where it did and vice versa? Do these findings support what you see in your own community? How do these findings make you feel about the health care delivered in Texas?

Case Study

Skolnikland is in Eastern Africa, with a population of 30 million people. The country has a plains region, a hill region, and a region with high mountains. It has a number of ecosystems. The plains are dry for much of the year, there is some rainforest, and the rest of the country includes both hills and mountains. There are two seasons of heavy rainfall.

The citizens come from several ethnic groups that tend to live in their own regions and speak different languages. The ethnic groups largely follow one of three different religions. The large cities are mixed ethnically. One ethnic group is economically and socially very dominant. The people from this group live in the capital and most of the large cities. The national language is the language of this dominant ethnic group.

According to World Bank criteria, Skolnikland is among the poorest countries in the world. The economy has been growing at about 4% per year on average over the last decade, but the economy had very slow economic growth in the decades prior to that. The richest 10% of the population controls 80% of the national income.

About 80% of the people live in rural areas and 20% in urban areas. The number of people living in urban areas has been growing recently at an increasing pace. Most people earn their livelihood in agriculture but there is an increasing garment manufacturing industry in the two largest cities. There are also a number of mining industries. In addition, other export industries are beginning to grow, mostly focused on the export of commodities to China.

The total fertility rate is about 4.5 but it has been declining slowly over the last two decades, from over 6. There is an almost equal number of men and women in the population. Infant mortality is about 90 per 1,000 live births. Maternal mortality is about 500 per 100,000 live births. Thirty-five percent of the children are underweight for age.

The adult literacy rate is about 40%. The educational enrollment rate, especially for girls at the primary and secondary levels, has been growing slowly, but steadily. Most recently, this rate has been growing at an increasing pace and about 75% of the girls now attend school regularly, although many of them are of very low quality.

Only about 50% of citizens have access to safe water. Only about 30% have access to sanitary disposal of human waste.

HIV prevalence is 7% of the adult population. The number of new HIV cases annually has begun to plateau. About half of the people eligible for treatment for HIV are on treatment. Malaria is rampant in the plains.

Investments in the road system have been growing at a solid pace in the last decade and the use of private automobiles has begun recently to increase more rapidly.

Skolnikland has a pluralistic health system that is made up of public and private institutions, publicly financed providers, licensed private providers, unlicensed medical practitioners, and traditional healers. There is no health insurance, except for some free services for the poor in the few publicly financed hospitals, which the better off people do not attend. The health system is not very effective or efficient and is generally of low quality. The HIV, TB, and malaria programs are not effective or efficient and they are just beginning to adopt paradigms for services that follow global best practices.

QUESTION 26

What is a DALY?